Delusions in Patients with Dementia with Lewy Bodies and the Associated Factors.

Ray-Chang Tzeng,Tzu-Yuan Wang,Pai-Yi Chiu,Ching-Fang Tsai,Ching-Tsu Wang

doi:10.1155/2018/6707291

Abstract

Objective Delusions are common neuropsychiatric symptoms in patients with dementia with Lewy bodies (DLB). The aim of this study was to investigate the associated factors of delusions in patients with DLB. Method A retrospective study of outpatients with DLB registered in a regional hospital's database was performed. The associated factors including cognitive performance, clinical features, vascular risk factors, and neuropsychiatric symptoms between delusional and nondelusional patients with DLB were compared. Results Among 207 patients with DLB, 106 (51.2%) were delusional and 101 (48.8%) were not. Delusion of other persons are stealing was the most common symptom (35.3%). The delusional group had a significantly higher diagnostic rate of probable than possible DLB, higher disease severity, poorer cognitive performance, more severe neuropsychiatric symptoms, and higher caregiver burden (all p < 0.05). In addition, the delusional group had a significantly lower frequency of diabetes compared to the nondelusional group (odds ratio = 0.28, p < 0.001). Conclusion Delusion of other persons are stealing was the most common delusional symptom. The patients with DLB who presented with delusions had poorer cognitive function and more severe neuropsychiatric symptoms. A novel finding is that the DLB patients with diabetes had a lower frequency of delusions.

Highlights

Dementia with Lewy bodies (DLB) is the second most common degenerative dementia
From October 1, 2015, to June 21, 2017, a total of 207 patients who fulfilled the criteria for DLB and had complete data were analyzed
The severity of delusions among the delusional patients according to the composite score of delusion in the Neuropsychiatric Inventory (NPI) was not different among the Clinical Dementia Rating (CDR) groups (4.8 ± 3.7 in CDR 0.5, 4.6 ± 2.1 in CDR 1, and 4.9 ± 2.9 in CDR 2–3; f = 0 481, p = 0 620)

Summary

Introduction

Dementia with Lewy bodies (DLB) is the second most common degenerative dementia. According to the first consensus criteria for the diagnosis of DLB in 1996, it accounts for about 20% of all clinical and autopsy cases of degenerative dementia [1]. In a more recent systemic review of studies on the incidence and prevalence of DLB in 2005, it was reported to account for 0 to 30.5% of all dementia cases [2]. Delusions are among the most common neuropsychiatric features in patients with dementia, especially in those with DLB. Delusions become one of the supportive features for the clinical diagnosis of DLB [1, 3]. Studies on delusions in dementia have shown that delusions are seldom observed in the predementia stage; delusions increase in frequency from the early through the later stages of dementia [4,5,6,7,8]

Methods

Results

Conclusion